临床表现 - 中山大学精品课程.pptVIP

Viral Hepatitis Introduction Viral hepatitis are a group of diseases, Caused by A、B、C、D and E 5 hepatitis virus Hepatitis A and E Transmitted by fecal-oral route, present acute and self-limited course Hepatitis B ,C and D Spread parenterally easily lead to chronic hepatitis Clinical characters including fatigue, intestinal symptoms tender and enlarged liver abnormal LFTs jaundice in some cases very variable in severity Significance Highly endemic Wide clinical spectrum High fatality rate in severe cases No specific pathogenic therapy available now Chronic hepatitis B and C very common, some may develop to cirrhosis even HCC Successful vaccination for HBV and HAV Etiology-HAV Heparnavirus Appeared in bile and feces, spreaded via feces No chronic carrier status observed Anti-HAV antibody to HAV Anti-HAV IgM indicative of current or recent infection appeared very early, disappear in about 3months most useful for confirm the diagnosis Anti HAV IgG current or previous infection a protective antibody, conferring immunity persist for life long time Etiology-HBV Orthohepadnavirus, Dane particle 4 open reading frame: S,C,P,X 8 genotypes A-H, B and C predominantly in China Strong ability against to environment 3 antigen and antibody system HBsAg found in serum and other body fluid not infectious itself suggesting current infection and infectivity Anti-HBs a protective antibody to HBsAg an indicator of past infection and immunity to HBV reinfection suggesting non-infectious HBeAg suggesting HBV replication and high infectivity negative when pre-C mutation but with high level of replication useful for evaluation of anti-HBV therapy Anti-HBe antibody to HBeAg HBe seroconversion HBeAg(+) →(-)and anti-HBe(-) →(+) HBcAg existing in th